The benefits of stapler tractor dissociating segmental bronchus in lung segmentectomy: A retrospective cohort study in a single center
- VernacularTitle:直线切割缝合器牵引装置在肺段切除术中离断段支气管的单中心回顾性队列研究
- Author:
Bin ZHANG
1
;
Jianan ZHENG
2
;
Liang CHEN
2
;
Quan ZHU
2
;
Jian ZHU
3
,
4
;
Wei WEN
2
Author Information
1. Department of Thoracic Surgery, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang, 242400, Jiangsu, P. R. China
2. Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, P. R. China
3. Department of Thoracic and Cardiovascular Surgery, General Hospital of Central Theater Command of the People'
4. s Liberation Army, Wuhan, 430070, P. R. China
- Publication Type:Journal Article
- Keywords:
Lung segmentectomy;
surgical technique;
stapler tractor;
flat tube tractor;
surgical quality evaluation;
surgical video replay
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(10):1434-1441
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the benefits of using a stapler tractor in the treatment of segmental bronchus during lung segmentectomy through detailed video replay analysis of surgical procedures. Methods We collected data from patients who underwent segmentectomy performed by the same surgical team in the Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, from November 2020 to August 2023. After excluding data that lacked analysis parameters, the remaining patients were divided into four groups based on the methods used for dissociating segmental bronchus: a stapler tractor group (group A), a stapler with bronchial stretching group (group B), a stapler only group (group C), and a silk ligature group (group D). Then, we compared baseline data and videotaped surgical details across all groups. Surgical details included the success rate of one-time segmental bronchus dissociation and severance, the time taken for successful one-time dissociation and severance of the segmental bronchus, the incidence of bleeding during bronchus dissociation, the conversion rate to thoracotomy during surgery, and surgical outcomes such as total operative time, postoperative hospitalization days, postoperative thoracic drainage volume, and pulmonary air leakage rate. Results The study included 325 patients (203 in the group A, 62 in the group B, 29 in the group C, and 31 in the group D). There was no statistically significant difference in baseline data among the four groups. However, significant differences were found in terms of total operation time, postoperative hospitalization days, intraoperative blood loss, segmental bronchial stump length, postoperative air leakage rate, hemorrhage rate during segmental bronchial dissociation, and conversion to thoracotomy rate among the four groups (P<0.05). Conclusion Using a stapler tractor for dissociating segmental bronchus in lung segmentectomy results in shorter operative time, less risk of intraoperative bleeding, and less surgical complications. This study provides valuable evaluation methodologies through the analysis of video replay surgical details, contributing to the improvement of lung segmentectomy quality.
